Whether it’s playing the piano, hitting a baseball or selling automobiles, it’s important for people to practice their craft. That paradigm is also true in training for an active shooting incident, and companies, schools, churches and even first responders are learning more about the importance of practicing survival training.

“The main thing is to practice and train for it; that’s the only way to be prepared,’’ said Sgt. Kathy Kelsheimer, a retired Marine police sergeant who is an expert on active attacker response and survival training. “To borrow a quote from Mike Tyson, ‘Everyone has a plan, until they get punched in the face.’”

Training to survive an active shooting incident is more critical than ever before. An FBI report released in May stated that more than 200 people were killed and 722 wounded in 50 active shooter incidents in the United States in 2016 and 2017. The shootings occurred at schools, nightclubs, concerts and even churches.

“What place is safe in our world?” said Dr. Kathy Platoni, a clinical psychologist and retired U.S. Army colonel, who is also an expert on post-traumatic stress disorder (PTSD). She survived the shootings at Fort Hood, Texas in 2009, which killed 14 people . “A school? A corporation? A hospital? It doesn’t exist.”

Why is practice necessary? Kelsheimer said heightened tension in an active shooting situation can dramatically impact a person’s fine motor skills. Even for experienced first responders, the difference between book and classroom training and a well-choreographed simulated incident can be revealing. “When you lose your fine motor skills, and you go to lock a door and you can’t, that’s surprising. The classroom is a lot different than a real situation.”

Kelsheimer attended a recent training session where an emergency rescue worker froze during a simulated training exercise. The drill mirrored the events of the 2016 shooting at the Pulse nightclub in Orlando, Florida. Fifty people died in that attack. The simulated training includes the nightclub haze, loud music and an area jammed with people – all reminiscent of the atmosphere at the time of the attack.

Businesses, schools and even churches are doing more to educate people about how to properly respond during an active shooting situation. Greg Buxton helped bring a training session to his employer, an automobile manufacturer in Ohio. About 35 employees and local fire department/EMS and law enforcement attended a two-day training exercise. “It’s not getting any better,’’ said Buxton, an engineering coordinator and medical team captain for his employer. “You can damn near every day hear another story about workplace violence. The company realized that we need training.”

Marvin Rutter spent 26 years in law enforcement and now is the director of safety and security at his school and church, also in Ohio. His team includes 42 people divided into four teams. On any given Sunday, the number of worshippers at church services can approach 1,200 people. “Some of those who know we do the training are thankful for what we do,’’ Rutter said. “Maybe 20 to 25 percent are not even aware that we carry concealed. For the most part, they’re willing to recognize the need and have a level of comfort that people can render aid.”

Training programs vary. For example, the Federal Emergency Management Agency conducts a one-hour course that “provides guidance to individuals, including managers and employees, so that they can prepare to respond to an active shooter situation.” The training sessions in which Buxton and Rutter participated included hands-on drills taught under life-like scenarios with the complete set of tools needed for survival and trauma treatment. Those tools included pre-made kits with tourniquets, dressings, gloves, tape, chest seals, and step-by-step directions to help walk the user through the treatments and guidance for communication with outside EMS.

Hopefully, businesses, schools and other organizations will never need to apply their active shooter training. But if a crisis situation does occur, having more people with the skills and knowledge to respond appropriately can save lives.

“When the stress inoculation occurs, it allows a responder to take all the new skills and put them together in life-saving situations,’’ said Kent Grant, a retired detective. “Through repetition and constant encouragement, a responder gets to where it all starts to come together for them. They are able to remember training, be calm and apply the medicine to save lives.”